School of Clinical Medicine (ETDs)
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Browsing School of Clinical Medicine (ETDs) by SDG "SDG-4: Quality education"
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Item A survey of current practice in anaesthesia for caesarean delivery in a Department of Anaesthesiology(2024) Watermeyer, Benjamin DavidSouth Africa has an increasing caesarean delivery (CD) rate and as such anaesthesia for CD has become a fundamental skill for all levels of anaesthetists. The Essential Steps in the Management of Obstetric Emergencies (ESMOE) guidelines provide a framework for practitioners with specific focus on dosage in neuraxial anaesthesia, perioperative fluids and management of hypotension. Aims The aim of this study was to describe the current practices of anaesthesia for patients requiring CD, including the management practices of common complications, within the University of the Witwatersrand Department of Anaesthesiology. Methods: A prospective, contextual and descriptive study design was followed using an anonymous, self-administered online questionnaire. Descriptive statistics were used to assess adherence to guidelines and comparison made between senior and junior anaesthetist’s practices. Results: Junior anaesthetists performed significantly more CD anaesthetics per month and had more training in ESMOE guidelines compared to senior anaesthetists. Senior anaesthetists were more likely to use a higher dose of bupivacaine. Phenylephrine as a first line anti-hypotensive agent was used by 99.4% of participants. The considered safe minimum platelet count for spinal anaesthesia was 75 x 10^9/l by 61.3% of participants. A significant difference between junior and senior anaesthetists was found where senior anaesthetists were more likely to accept a lower platelet count. A sensory level post administration of spinal anaesthetic was assessed by all participants with 53.1% using an ice brick and 35.0% requesting the surgeon to pinch the patient. Conclusion: In the Witwatersrand Department of Anaesthesiology anaesthetists do follow the ESMOE guidelines of clinical practice for CD. While there are some differences in practice approaches, these were found to be within internationally accepted practice. There would be a benefit of improved awareness of the ESMOE guidelines within the department as well as further training on the different approaches to CD anaesthesia.Item Adequacy of availability of antidotes for common and critical drug poisonings and doctors’ perspectives thereof: a study in teaching hospitals in the Southern Gauteng City-Region(2024) Fitchett, Margaret PenelopeBackground: Drug poisoning is an important area of study in South Africa (SA) as a treatable cause of mortality. While research has been conducted on poisoning, there is a paucity of literature on the availability of antidotes in SA. Objectives: To assess the availability of antidotes in selected teaching hospitals in the Southern Gauteng City-Region and to explore doctors’ experiences of antidote supply. Methods: A data sheet assessing the availability of antidotes in the Emergency Departments (EDs) and pharmacies was completed in person at each of the teaching hospitals. A questionnaire exploring experiences of antidote supply was distributed to 126 doctors working in the EDs. Results: N-acetylcysteine, atropine, diazepam, clonazepam, sodium bicarbonate, vitamin K, calcium gluconate, naloxone, ethanol and pyridoxine were present in all EDs. Doctors reported organophosphate poisoning and paracetamol overdose as the most common drug poisonings (81.7% and 14.3% of 126 respondents respectively). Most doctors experienced no supply issues for N-acetylcysteine, calcium gluconate, sodium bicarbonate or pyridoxine (85.7%, 83.3%, 87.3% and 75.4% of 126 respondents respectively). Conclusion: The antidotes to the most common poisonings reported by doctors were present in all EDs. However, concerns were raised about consistency of supply which will be an important avenue for further research.Item Students’ perceptions of the medical curriculum at the University of Limpopo(2024) Mamashela, Thakadu ArnoldAny educational program follows a process of development by various stakeholders. Program evaluation is an important step in curriculum development and implementation. This study evaluated the medical curriculum delivery from the perspective of the students at the new medical school of the University of Limpopo. The research employed a cross-sectional descriptive quantitative method using a survey. All students registered for the medical curriculum in their second to fifth years of study were invited to participate in the research. The findings of this research showed there was a perception of factual overload in some modules, however, most of the modules were perceived to have been well taught with mixed methods of assessment strategies applied across the year levels of study. The infrastructure and the equipment required for teaching and learning activities were not considered satisfactory. Students embraced the use of technology in teaching and learning. The university provided adequate support in relation to WiFi on campus. Recommendations for teaching/ practice and future research were made.